Rapid Evolution of an Iatrogenic Cerebral Amyloid Angiopathy

A 38-year-old patient presented with isolated cognitive complaints.He had a history of traumatic brain injury at age 9 months with parietal hematoma evacuation.Surgical details, including potential cadaveric material use, were unavailable.Initial MRI revealed past hemorrhage first attributed to the trauma.Months later, he developed headaches and right hemiplegia, revealing an acute lobar hematoma.Over 3 years, he experienced 2 more deficit episodes and progressive cognitive decline.Serial MRI revealed rapidly worsening hemorrhagic anomalies (Figure 1).CSF showed reduced -amyloid (A) 42 and normal tau.Apolipoprotein E genotype was 2/3 and amyloid protein precursor mutation screening was negative.